Exercise and Pregnancy

“Challenging exercise and strength training are not recommended during pregnancy right?”

Participation in exercise for women after puberty is already low, yet it is being compounded by fear-mongering about completing tolerable but challenging exercise during pregnancy, which when avoided has lifelong negative impacts on women's health both during and after pregnancy. Exercise that does not involve risk of direct blows to the abdomen seems very safe at all stages of pregnancy, and exercising as a young or experienced parent is recommended for your children's physical and psychological growth. Also, to be clear, not following exercise guidelines and being sedentary, despite well-intended beliefs that it will protect your unborn child, is harmful for your child's long term health. Benefits of regular exercise for you and your child’s current and future health vastly outweigh any risk of harm. 

• Evidence-based physical activity guidelines for pregnancy

• Australian Government Department of Health, Disability and Ageing

• Evidence-based physical activity guidelines for pregnant women 

• Exercise During Pregnancy | ACOG

• Program for Pregnancy & Postpartum Health

• Beneficial Effects of Maternal Physical Activity during Pregnancy on Fetal, Newborn, and Child Health: Guidelines for Interventions during the Perinatal Period from the French National College of Midwives - PMC

• Episode #167: Exercise In Pregnancy Barbell Medicine podcast 

• The Postpartum Playbook with Margie Davenport. EP#576 | BJSM Podcast + Pregnancy Exercise Scientist: How to Exercise Safely During Pregnancy - YouTube 

• Physical activity during pregnancy 2011–12, Summary - Australian Institute of Health and Welfare

• Pregnancy, birth and baby | Australian Government Department of Health, Disability and Ageing

• Maternal Cardiac Adaptations to a Physical Exercise Program during Pregnancy  

• Spotlight on Exercise during and after pregnancy Table of contents | British Journal of Sports Medicin

• Championing Motherhood: Exercise And The Pregnant Athlete - Gatorade Sports Science Institute

• Impact of postpartum physical activity on cardiometabolic health, breastfeeding, injury, and infant growth and development: a systematic review and meta-analysis | British Journal of Sports Medicine

• Association between Cardiorespiratory Fitness and Hypertensive Disorders of Pregnancy 

• Sedentary Behavior and Light-Intensity Physical Activity During Pregnancy and Cardiovascular Health: A Science Advisory From the American Heart Association | Circulation

• The Role of Physical Activity in Preconception, Pregnancy and Postpartum Health

• Evidence-based physical activity guidelines for pregnant women 

• Morphometric and neurodevelopmental outcome at age five years of the offspring of women who continued to exercise regularly throughout pregnancy - PubMed 

• Infant lung function and maternal physical activity in the first half of pregnancy

• (Maternal and Fetal Cardiovascular Responses to Acute High-Intensity Interval and Moderate-Intensity Continuous Training Exercise During Pregnancy: A Randomized Crossover Trial) ”An acute bout of HIIT exercise consisting of repeated 1-min near-maximal to maximal exertions, as well as MICT exercise, is well tolerated by both mother and fetus.”

• Sports advice: 

  • Pregnancy Exercise Scientist: How to Exercise Safely During Pregnancy - YouTube + Stay in play paper.pdf - Google Drive + FIFA_StayInPlay.pdf - Google Drive  

• Helpful for fertility outcomes and the normal stress involved in trying to get pregnant when paired with good nutrition:

  • The effect of physical activity on fertility: a mini-review

  • Physical activity and fertility 

What about Strength training?

• Even concerns about strenuous strength training are being challenged by updated research, which shows benefits for women, especially when strength training is done before pregnancy, a practice recommended for all women anyway (Resistance training in pregnancy: systematic review and meta-analysis of pregnancy, delivery, fetal and pelvic floor outcomes and call to action + Effects of strength training on quality of life in pregnant women + Evidence for resistance training during pregnancy + Benefits of Resistance Training During Pregnancy for Maternal and Fetal Health + High-Load Resistance Training in the First Trimester).

  • (Impact of heavy resistance training on pregnancy and postpartum health outcomes) “Individuals who engaged in heavy prenatal resistance training had typical perinatal and pelvic floor health outcomes that were not altered whether they engaged in, or avoided Olympic lifting, Valsalva, or supine weightlifting.”

  • (Maternal and fetal responses to acute high-intensity resistance exercise during pregnancy) “....all participants in the study had a background in resistance training (range of experience: 2–20 years)......Our findings suggest that high-intensity resistance exercises“ including barbell squats, lying flat bench press and deadlifts “are well tolerated by both mother and fetus, including while using the Valsalva manoeuvre” a form of intentional breath holding. 

  • (Pushing limits: the acute effects of a heavy-load resistance protocol and supine exercise on fetal well-being) “results indicate that highly active women, especially those with resistance training experience, can safely engage in a heavy-load resistance protocol, including supine exercise, without jeopardising fetal well-being.”

  • Is strength training while lying on your back (exercising “supine” in medical jargon) harmful? 

    • (Is supine exercise associated with adverse maternal and fetal outcomes? A systematic review | British Journal of Sports Medicine) There was “insufficient evidence to ascertain whether maternal exercise in the supine position is safe or should be avoided during pregnancy.”

    • See Pushing limits: the acute effects of a heavy-load resistance protocol and supine exercise on fetal well-being - PMC and Maternal and fetal responses to acute high-intensity resistance exercise during pregnancy + Resistance Training Does Not Decrease Placental Blood Flow During Valsalva Maneuver for proof of safety.

      
      

Post pregnancy recommendations.

• Return to exercise/running post-partum can be done safely and has huge benefits for you and your child's current and future health:

  • Return to running post-partum – when, what, and how? | BJSM Podcast

  • 2025 Canadian guideline for physical activity, sedentary behaviour and sleep throughout the first year post partum | British Journal of Sports Medicine

  • Grainne Donnelly and Emma Brockwell – Post-Partum Return To Running Guidelines – The Women’s Health Podcast

  • Clinical and exercise professional opinion of return-to-running readiness after childbirth: an international Delphi study and consensus statement | British Journal of Sports Medicine + Clinical and exercise professional opinion on designing a postpartum return-to-running training programme: an international Delphi study and consensus statement | British Journal of Sports Medicine 

  • International Delphi study of clinical and exercise professionals’ opinion of physical activity prescreening and contraindications for participating in postpartum physical activity | British Journal of Sports Medicine

  • Impact of postpartum physical activity on cardiometabolic health, breastfeeding, injury and infant growth and development: a systematic review and meta-analysis | British Journal of Sports Medicine 

  • (Breastfeeding-injury link: are concerns warranted? | British Journal of Sports Medicine) “breastfeeding did not increase the risk of musculoskeletal injury during the postpartum period. Maintaining preconception physical activity during pregnancy may reduce the risk of postpartum injury.”

  • (Impact of postpartum exercise on pelvic floor disorders and diastasis recti abdominis: a systematic review and meta-analysis) “Evidence supports the effectiveness of postpartum pelvic floor muscle training in reducing the odds of urinary incontinence and pelvic organ prolapse”

  • “an effective intervention to improve postpartum anthropometrics” meaning exercise is helpful for improving body composition (decreased fat gain and increased muscle mass) (Impact of postpartum physical activity on maternal anthropometrics: a systematic review and meta-analysis | British Journal of Sports Medicine)

  • Return to sport:

    • Pregnancy Exercise Scientist: How to Exercise Safely During Pregnancy - YouTube + Stepping into play paper.pdf - Google Drive + FIFA_Stepintoplay.pdf - Google Drive  

  • Post-partum related hip/pelvic pain can be managed with exercise:

    • Pelvic girdle pain myths infographic

    • Impact of postpartum exercise on pelvic floor disorders and diastasis recti abdominis: a systematic review and meta-analysis

Exercise before, during, and after pregnancy has heaps of benefits for you and your future child (50 benefits of strength training + 50 Benefits of Aerobic Training or Planned Physical Activity). Imagine what your body would feel like if you took nine months off from exercise when not pregnant. You should not do the same when pregnant or when tolerating being a new parent.